Allen Mia I, Nader Michael A
Department of Translational Neuroscience, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1083, USA.
Trends Pharmacol Sci. 2025 Mar;46(3):220-230. doi: 10.1016/j.tips.2025.01.003. Epub 2025 Jan 28.
Cocaine-use disorders (CUDs) continue to be a major public health problem that requires effective treatments. Despite decades of preclinical research, there are no FDA-approved pharmacotherapies for cocaine use. While there are numerous potential reasons why no efficacious treatments have been identified or approved for cocaine use, we discuss two possible reasons in this review: the low number of studies incorporating social variables and the overlooking of the clinical reality of polysubstance use. These variables impact drug use across the substance-use cycle, including vulnerability, maintenance, and treatment. Recent preclinical and clinical data suggest that cocaine users who engage in polysubstance use should be viewed as a distinct and more prevalent population who require unique behavioral and pharmacological approaches to reduce cocaine use. Therefore, to understand the neurobiology and eventual treatments for CUDs, both variables should be included in animal models.
可卡因使用障碍(CUDs)仍然是一个需要有效治疗的重大公共卫生问题。尽管进行了数十年的临床前研究,但尚无美国食品药品监督管理局(FDA)批准的用于治疗可卡因使用的药物疗法。虽然尚未确定或批准有效治疗可卡因使用的原因众多,但我们在本综述中讨论两个可能的原因:纳入社会变量的研究数量较少以及对多物质使用临床现实的忽视。这些变量在整个物质使用周期中影响药物使用,包括易感性、维持使用和治疗。最近的临床前和临床数据表明,使用多种物质的可卡因使用者应被视为一个独特且更普遍的群体,他们需要独特的行为和药理学方法来减少可卡因使用。因此,为了了解CUDs的神经生物学及最终治疗方法,动物模型中应纳入这两个变量。